The association between Betel Quid Chewing and Metabolic Syndrome among urban adults in Mandalay District of Myanmar / Journal of the ASEAN Federation of Endocrine Societies

Background@#As the prevalence of metabolic syndrome, obesity and diabetes increase worldwide, the need to identify modifiable lifestyle risk factors also increases, especially those that may be relatively unique to a specific population. To explore a possible association between betel quid chewing and metabolic syndrome, a community-based cross-sectional study was conducted.@*Methodology@#Three hundred ninety-one (391) adults were interviewed and the following parameters were measured: triglycerides, HDL-cholesterol, glucose, waist circumference, body mass index and blood pressure. Multiple logistic regression was used to determine the association between betel quid chewing and metabolic syndrome while controlling for confounders.@*Results@#The prevalence of metabolic syndrome was similar in chewers and non-chewers, 50% and 49%, respectively. After controlling for other factors, development of metabolic syndrome was positively associated with number of betel quid chewed per day, age greater than 40 years , and a positive family history of hypertension and diabetes. Regarding the duration of betel chewing, when analyzed by sex, the risk was doubled in men compared to non-chewers (OR 2.15; 95% CI = 1.21, 3.84]). As a result, a man chewing more than 10 pieces (OR 2.49; 95% CI = 1.36, 4.57]) of betel quids per day for more than 10 years had a two-fold increased chance of developing the metabolic syndrome.@*Conclusions@#Frequency and duration of betel quid chewing may represent a behavioral lifestyle target for approaches to reduce the incidence of metabolic syndrome.

Peri-implant clinicoradiographic status among betel-quid chewers and controls

Abstract The aim of the present case-control observational study was to evaluate the peri-implant clinicoradiographic status among betel-quid chewers and controls. Self-reported betel-quid chewers and controls were included. Participants were categorized into 3 groups: Group-1: Individuals chewing betel-quid with tobacco; Group-2: Individuals chewing betel-quid without tobacco; and Group-3: Controls (individuals not using tobacco in any form). Demographic data was collected using a questionnaire. Periodontal and peri-implant clinicoradiologic parameters (plaque and gingival indices [PI and GI], probing depth [PD] and crestal bone loss/marginal bone loss [CBL/MBL]) were assessed. Clinical attachment loss (AL) around teeth was also assessed. Group comparisons were done using the one-way analysis of variance and Bonferroni Post-hoc adjustment tests. Correlation of periodontal and peri-implant inflammatory parameters with the duration of betel-quid chewing habit and duration of placement in the mouth were assessed using logistic regression analysis. P<0.05 was considered statistically significant. Thirty, 30 and 30 patients were included in groups 1, 2 and 3, respectively. Full-mouth PI (P<0.01), GI (P<0.01), clinical AL (P<0.01), PD (P<0.01) and mesial and distal MBL (P<0.01) were higher in groups 1 and 2 than Group-3. Peri-implant mPI (P<0.01), mGI (P<0.01), PD (P<0.01) and MBL/CBL (P<0.01) were significantly higher in groups 1 and 2 than Group-3 with no significant difference in groups 1 and 2. Betel-quid chewing habit either with or without tobacco is a risk-factor of peri-implant soft-tissue inflammation and CBL.

Resumo O objetivo do presente estudo observacional de casos-controles foi avaliar o estado clínico-radiográfico periimplantar dos usuários de bétele. Foram incluídos usuários que relataram utlizar a substância bétele como tabaco de mascar. Os participantes foram categorizados em 3 grupos: Grupo-1: Indivíduos que mascam bétele com tabaco; Grupo-2: Indivíduos que mascam bétele sem tabaco; e Grupo-3: Controle (indivíduos que não usam tabaco sob qualquer forma). Os dados demográficos foram recolhidos utilizando um questionário. Foram avaliados parâmetros clínico-radiográfico e periimplantares (índices placa e gengivais [IP e IG], profundidade de sondagem [PS] e perda de crista óssea/ perda óssea marginal [PCO/POM]). Também foi avaliada a perda inserção clínica (IC) em torno dos dentes. As comparações de grupo foram feitas utilizando a análise de variância unidireccional e os testes de ajustamento post-hoc de Bonferroni. A correlação dos parâmetros inflamatórios periodontais e periimplantares com a duração do hábito de mastigação da bétele e duração da colocação na boca foi avaliada utilizando a análise de regressão logística. P<0,05 foi considerado estatisticamente significativo. Foram utilizados 30 pacientes em cada grupo. O IP de boca inteira (P<0,01), IG (P<0,01), IC clínica (P<0,01), PS (P<0,01) e POM mesial e distal (P<0,01) foram mais elevados nos grupos 1 e 2 do que no grupo 3. O mPI peri-implantar (P<0,01), '(P<0,01), PD (P<0,01) e POM/PCO (P<0,01) foram significativamente mais elevados nos grupos 1 e 2 do que no grupo 3, sem diferença significativa nos grupos 1 e 2. O hábito de mastigar a substância bétele com ou sem tabaco é um fator de risco de inflamação dos tecidos moles periimplantares e PCO.

Neuroimaging of Betel quid dependence / 中华行为医学与脑科学杂志

Betel quid dependence(BQD)is a chronic recurrent brain disease characterized by loss of self-control and compulsive repeated use of drugs,which conforms to the characterics of addictive behavior classified by the World Health Organization. Long term chewing Betel nut can increase the risk of a variety of cancers such as oral cancer. The BQD research lacks the ideal animal model whereas the mechanism of BQD is still not clear,and there is no effective treatment and prevention. Notably,neuroimaging technology has provided a non-invasive,quantitative assessment method for the neural mechanism of BQD. The author sum-marized the neural mechanism and imaging studies progress of BQD,and these findings provided preliminary objective evidence for the brain changes of BQD,which was helpful for the deep understanding of the neuro-pathic mechanism of BQD,and provided theoretical basis for the early intervention and treatment.

Neuroimaging of Betel quid dependence / 中华行为医学与脑科学杂志

Betel quid dependence(BQD)is a chronic recurrent brain disease characterized by loss of self-control and compulsive repeated use of drugs, which conforms to the characterics of addictive behavior classified by the World Health Organization.Long term chewing Betel nut can increase the risk of a variety of cancers such as oral cancer.The BQD research lacks the ideal animal model whereas the mechanism of BQD is still not clear, and there is no effective treatment and prevention. Notably, neuroimaging technology has provided a non-invasive, quantitative assessment method for the neural mechanism of BQD. The author summarized the neural mechanism and imaging studies progress of BQD, and these findings provided preliminary objective evidence for the brain changes of BQD, which was helpful for the deep understanding of the neuropathic mechanism of BQD, and provided theoretical basis for the early intervention and treatment.

Correlation of Betel Quid with Oral Cancer from 1998 to 2017: A Study Based on Bibliometric Analysis / 中华医学杂志(英文版)

Background@#Betel quid chewing has been a major risk factor for oral cancer (OC) in southern China. This study aimed to analyze the scientific publications on the relationship between betel quid chewing and OC and construct a model to quantitatively and qualitatively evaluate pertinent publications from 1998 to 2017.@*Methods@#The publications from 1998 to 2017 were retrieved from the Web of Science Core Collection database. Microsoft Excel, Thomson Data Analyzer, VOSviewer, and CiteSpace software were used to analyze the publication outcomes, journals, countries/regions, institutions, authors, research areas, and research frontiers.@*Results@#A total of 788 publications on the relationship between betel quid chewing and OC published until October 25, 2017, were identified. The top 4 related journals were Journal of Oral Pathology Medicine, Oral Oncology, Plos One, and International Journal of Cancer. The top five countries engaged in related research included China, India, the United States, the United Kingdom, and Malaysia. The corresponding disciplines, such as oncology, oral surgery, pathology, environmental and occupational health, and toxicology, were mainly concentrated in three disciplines. The subject terms squamous cell carcinoma, OC, betel quid, expression, oral submucous fibrosis, India, and p53 ranked first among research hotspots. The burst terms squamous cell carcinoma, OC, betel quid, and expression ranked first in research frontiers.@*Conclusions@#Research in this area emphasized hotspots such as squamous cell carcinoma, OC, oral submucosal fibrosis, betel quid, and tobacco. The annual number of publications steadily decreased from 1998 to 2017, with a lack of a systematic study from interdisciplinary perspectives, inadequate pertinent journals, limited regions with the practice of betel quid chewing, and insufficient participation of researchers, which indicate that as the prevalence of OC increases, particularly in China, research in this area warrants further expansion.

Characterization of bacteria in betel quiz chewers and non- chewers and their associated oral health status

Aim: To evaluate oral health status, periodontal status, gingival status, oral lesions and bacterial characterization among betel quid chewers and non chewers. Material and Methods: The data was collected regarding socio-demographic characteristic, oral hygiene status, gingival status, periodontal status, bacterial characterization among betel quid chewers and non chewers. The microbiological examination was carried out to assess the micro flora. The statical analysis was done by using SPSS version 21(Chicago ,USA). The p value≤ 0.05 was found to be statistically significant. Results: Aerobic as well as anaerobic bacteria were more characterized among quid chewers as compared to non quid chewers. Significant co-relation was found between oral hygiene status and gingival status ,CPI and LOA, oral lesions and bacterial characterization among quid chewers characterization (r=0.391, 0.932, 572 respectively p-value=0.000, S) and among non quid chewers significant correlation was found between CPI and LOA scores (r=0.658 p-value=0.000, S). Conclusions: Chewing betel quid has been found in role of detoriation of oral hygiene gingival status periodontal status and also development of oral lesions.

Tobacco: Culture and legislature worldwide.

Oral cancer affects as many as 274000, people worldwide annually. Tobacco use is one of the major preventable cause of premature death and disease in the world. TSNAs are considered the most potent classes of carcinogens with N-nitrosonornicotine (NNN) and 4- (methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK). Risk Factors for Smoking includes family factors, school factors, peer factors, community factors, stress and domestic violence. Tobacco is an integral part of the culture and tradition in many countries of the South-East Asia Region. Tobacco use resulting in 5.4 million deaths every year. A new term, "thirdhand" smoke, has been proposed to describe the particulate residual toxins deposited in layers all over the home furniture after a cigarette has been extinguished. Many countries are putting ban for smoking in public places. Half measures are not enough, when one form of advertising is banned; the tobacco industry simply shifts its vast resources to another channel. Governments are urged to impose a complete ban to break the tobacco marketing net. An effort is made to comprehend articles on tobacco by searched from journals through Google and Ebscohost.

Association Between Grading of Oral Submucous Fibrosis With Frequency and Consumption of Areca Nut and Its Derivatives in a Wide Age Group: A Multi-centric Cross Sectional Study From Karachi, Pakistan

BACKGROUND: Oral submucous fibrosis (OSMF) is a chronic, premalignant condition of the oral mucosa and one of the commonest potentially malignant disorders amongst the Asian population. The objective of this study was to investigate the association of etiologic factors with: age, frequency, duration of consumption of areca nut and its derivatives, and the severity of clinical manifestations. METHODS: A cross-sectional, multi centric study was conducted over 8 years on clinically diagnosed OSMF cases (n = 765) from both public and private tertiary care centers. Sample size was determined by World Health Organization sample size calculator. Consumption of areca nut in different forms, frequency of daily usage, years of chewing, degree of mouth opening and duration of the condition were recorded. Level of significance was kept at P < or = 0.05. RESULTS: A total of 765 patients of OSMF were examined, of whom 396 (51.8%) were male and 369 (48.2%) female with a mean age of 29.17 years. Mild OSMF was seen in 61 cases (8.0%), moderate OSMF in 353 (46.1%) and severe OSMF in 417 (54.5%) subjects. Areca nut and other derivatives were most frequently consumed and showed significant risk in the severity of OSMF (P < or = 0.0001). Age of the sample and duration of chewing years were also significant (P = 0.012). CONCLUSIONS: The relative risk of OSMF increased with duration and frequency of areca nut consumption especially from an early age of onset.

Smokeless tobacco use in Myanmar.

Smokeless tobacco (SLT) use in various forms is highly prevalent in Myanmar. The aim of this paper is to study the socio-cultural background of SLT use and products of SLT in Myanmar and the prevalence of SLT based on surveys and from other published data bases. Information was obtained from the literature review and through search on PubMed and Google. The use of SLT is deep rooted in Myanmar culture, and there is also wide-spread belief that it is not as dangerous as smoking. SLT use is growing in Myanmar. About 9.8% of the 13-15-year-old school children and 20.8% adults use SLT; it is many-fold higher among men. The use of SLT is prevalent using many different types of tobacco and forms of its use in Myanmar. The socio-cultural acceptance and the myths were compounded by the lack of specific SLT control component in the National Tobacco Control Legislation adopted needs to be addressed as a priority through intensified community awareness programs, public education programs, and advocacy campaigns. Effective enforcement of the law and amendment to include specific components of SLT in the provisions of the law is highly recommended. The prevalence of SLT is high among school children and adults (especially in men) in Myanmar. Betel quid and tobacco is a common form of SLT use. Although control of smoking and consumption of tobacco product law exists, its implementation is weak.

Betel quid chewing and its risk factors in Bangladeshi adults.

Background: Despite its ill effects, betel quid chewing is a common practice in the South-East Asia Region. However, so far no large-scale study had been conducted, hence, this study was aimed at estimating the extent of betel quid chewing and its association with socio-demographic factors in Bangladeshi adults. Methods: The data of a cross-sectional sample survey, involving 15 155 and 15 719 adults from rural and urban areas of Bangladesh respectively, were analyzed. Data were collected on betel quid chewing and socio-demographic characteristics by interview method using a pre-tested structured questionnaire. Anthropometric measurements were done following standard protocols. Results: Overall 31% of the study samples chewed betel quid regularly. Prevalence was two times higher in rural (43.2%) compared to the urban areas (19.1%). Betel quid use was more common among Hindus (41.4%), farmers (55.3%), and people in the 40-year or more (63.9%) age group; and the habit was less common in unmarried (1.6%) and educated persons (19.6%). Ex-smokers (73.8%) and current smokers (37.3%) were more likely to use betel quid than never smokers (25.6%). The frequency of betel quid chewing was 5.15 times a day which varied significantly with age, locality, religion and occupation. Three-fourths of the betel quid users chewed tobacco with it which was not influenced by socio-economic variables. On average, 2.29 Takas (USD 0.03) was spent a day on betel quid chewing. Conclusions: Betel quid chewing was found to be a common habit in Bangladesh. Mature adults (40+years) of low socio-economic status, i.e., rural residents, farmers and the illiterate are more likely to chew betel quid.

Oral submucous fibrosis as a precursor of malignancy - a case report

Oral submucous fibrosis (OSF) is a high risk precancerous condition predominantly occurs in Indians and other population of the Indian subcontinent with certain oral habits. Betel quid (BQ) chewing is a popular oral habit with potential links to the occurrence of oral cancer. In patients with submucous fibrosis, the oral epithelium becomes atrophic and thereby becomes more vulnerable to carcinogens. Since the ingredients of BQ, tobacco are crucial for tumour initiation, promotion and progression, exposure to these toxicants simultaneously has been shown to markedly potentiate the oral cancer incidence in OSF patients. The rate of malignant transformation of OSF has been estimated to be 4.5%. Most cases with malignant transformation in OSF had occurred gradually over a long period of time.

Effect of Tobacco Use On Oral Health- An Overview

Tobacco use is linked with many serious illnesses, such as cancer, cardiopulmonary diseases, as well as with many health problems. Every year, the use of tobacco products causes a heavy toll of deaths and severe human disease worldwide. One of the many health problems linked to tobacco use is its detrimental impact on oral health. Tobacco causes a whole series of oral health problems, ranging from life-threatening (precancerous changes leading to oral cancer) and serious (periodontal disease, teeth decay) to social (bad breath). Tobacco is consumed through the mouth in a variety of forms, varied from smoked tobacco to smokeless tobacco chewing on itself or combined with areca nut. All these forms of tobacco have damaging effects on the oral health. The most significant preventive measure to prevent the oral health problems caused by tobacco use is to stop using tobacco products. The risk of developing oral cancer drops rapidly when a smoker ceases tobacco use. After ten years of not using tobacco, an ex-smoker/user’s risk of oral cancers is about the same as that for someone who has never smoked. To stop using tobacco products is not an easy task. Fortunately, there are a number of therapies available to assist in quitting of tobacco. It is important to remember that, while it will be difficult, ceasing to use tobacco has immediate health benefits, including increased life expectancy and reduced risk of tobacco related diseases and conditions.